Wearable Knee Health Rehabilitation Assessment using Acoustical Emissions

Each year, approximately 200,000 Americans endure anterior cruciate ligament (ACL) tears, and 100,000 reconstructive procedures are conducted to repair the injured knees (1). The injury itself, and the long rehabilitation process that follows, can majorly disrupt the quality of life for these Americans through missed workdays, reduction of overall physical activity, and increased risk of re-injury in future activities. Wearable technologies for quantifying the state of rehabilitation, and providing feedback to the user regarding which activities or intensities of activities are safe to perform at any given time, could potentially help accelerate the rehabilitation process as well as reduce the risk of re-injury. Our lab has developed a novel, wearable sensing system based on miniature piezoelectric contact microphones for measuring the acoustical emissions from the knee during movements such as unloaded flexion / extension, sit-to-stand, and walking activities. The system consists of two Knowles BU-23173 contact microphones (Knowles, Itasca, IL) positioned on the medial and lateral sides of the patella, connected to custom, analog pre-amplifier circuits and a microcontroller for digitization and data storage on a secure digital (SD) card. In addition to the acoustical sensing, the system includes two integrated inertial measurement sensors including accelerometer and gyroscope modalities to enable joint angle calculations; these sensors, with digital outputs, are connected directly to the same microcontroller via serial peripheral interface (SPI). The system provides low noise, accurate joint acoustical emission and angle measurements in a wearable form factor, and has several hours of battery life. We have also taken measurements from healthy subjects, and athletes following acute ACL tear, to determine initial features from these acoustical emissions that are associated with injured versus healthy joints. We have found that the main acoustic clicks during particular motions occurred at consistent joint angles for healthy subjects based on intraclass correlation coefficient analysis (ICC(1,1) = 0.94 and ICC(1,k) = 0.99) (2). For one subject with an ACL tear, we found that the consistency of the joint acoustical emissions was lower for the injured knee as compared to the healthy knee in the recording immediately following the injury (\u3c 7 days), and improved following six months of rehabilitation. We envision using the wearable system we have recently completed to conduct further experiments with subjects following acute ACL tears, and tracking the progress of the rehabilitation while simultaneously measuring acoustical emissions in the context of particular movements. This data will then serve as a foundation for creating subject-specific algorithms for assessing rehabilitation and providing feedback to the users

Wearable technologies for knee health monitoring using bioimpedance and acoustical emissions

The objective of this work is to address the gap in the area of wearable knee joint health assessment. Knee injuries are among the most common reasons for doctor’s visits. The physical examinations of the joint during these visits are typically limited to qualitative observations. Examination methods based on diagnostic imaging are expensive and time consuming. Beyond the clinic, such as in the home or with wearable technologies, there are no viable solutions available for providing in-depth, quantitative joint health assessment. Developing novel, ubiquitous technologies for joint health assessment would enable personalized, feedback-controlled therapies for patients. Towards the proposed research goal, sensing systems and signal processing techniques that can provide biomarkers for knee joint health assessment are developed and discussed. Two types of physiological signals acquired from the knee joint are considered for this purpose: (1) electrical bioimpedance and (2) acoustic emission signals.Ph.D

Wearable Knee Health Rehabilitation Assessment using Acoustical Emissions

Each year, approximately 200,000 Americans endure anterior cruciate ligament (ACL) tears, and 100,000 reconstructive procedures are conducted to repair the injured knees (1). The injury itself, and the long rehabilitation process that follows, can majorly disrupt the quality of life for these Americans through missed workdays, reduction of overall physical activity, and increased risk of re-injury in future activities. Wearable technologies for quantifying the state of rehabilitation, and providing feedback to the user regarding which activities or intensities of activities are safe to perform at any given time, could potentially help accelerate the rehabilitation process as well as reduce the risk of re-injury. Our lab has developed a novel, wearable sensing system based on miniature piezoelectric contact microphones for measuring the acoustical emissions from the knee during movements such as unloaded flexion / extension, sit-to-stand, and walking activities. The system consists of two Knowles BU-23173 contact microphones (Knowles, Itasca, IL) positioned on the medial and lateral sides of the patella, connected to custom, analog pre-amplifier circuits and a microcontroller for digitization and data storage on a secure digital (SD) card. In addition to the acoustical sensing, the system includes two integrated inertial measurement sensors including accelerometer and gyroscope modalities to enable joint angle calculations; these sensors, with digital outputs, are connected directly to the same microcontroller via serial peripheral interface (SPI). The system provides low noise, accurate joint acoustical emission and angle measurements in a wearable form factor, and has several hours of battery life. We have also taken measurements from healthy subjects, and athletes following acute ACL tear, to determine initial features from these acoustical emissions that are associated with injured versus healthy joints. We have found that the main acoustic clicks during particular motions occurred at consistent joint angles for healthy subjects based on intraclass correlation coefficient analysis (ICC(1,1) = 0.94 and ICC(1,k) = 0.99) (2). For one subject with an ACL tear, we found that the consistency of the joint acoustical emissions was lower for the injured knee as compared to the healthy knee in the recording immediately following the injury (< 7 days), and improved following six months of rehabilitation. We envision using the wearable system we have recently completed to conduct further experiments with subjects following acute ACL tears, and tracking the progress of the rehabilitation while simultaneously measuring acoustical emissions in the context of particular movements. This data will then serve as a foundation for creating subject-specific algorithms for assessing rehabilitation and providing feedback to the users.</p

A Wearable Patch to Enable Long-Term Monitoring of Environmental, Activity and Hemodynamics Variables

We present a low power multi-modal patch designed for measuring activity, altitude (based on high-resolution barometric pressure), a single-lead electrocardiogram, and a tri-axial seismocardiogram (SCG). Enabled by a novel embedded systems design methodology, this patch offers a powerful means of monitoring the physiology for both patients with chronic cardiovascular diseases, and the general population interested in personal health and fitness measures. Specifically, to the best of our knowledge, this patch represents the first demonstration of combined activity, environmental context, and hemodynamics monitoring, all on the same hardware, capable of operating for longer than 48 hours at a time with continuous recording. The three-channels of SCG and one-lead ECG are all sampled at 500 Hz with high signal-to-noise ratio, the pressure sensor is sampled at 10 Hz, and all signals are stored to a microSD card with an average current consumption of less than 2 mA from a 3.7 V coin cell (LIR2450) battery. In addition to electronic characterization, proof-of-concept exercise recovery studies were performed with this patch, suggesting the ability to discriminate between hemodynamic and electrophysiology response to light, moderate, and heavy exercise

A Wearable Patch to Enable Long-Term Monitoring of Environmental, Activity and Hemodynamics Variables

We present a low power multi-modal patch designed for measuring activity, altitude (based on high-resolution barometric pressure), a single-lead electrocardiogram, and a tri-axial seismocardiogram (SCG). Enabled by a novel embedded systems design methodology, this patch offers a powerful means of monitoring the physiology for both patients with chronic cardiovascular diseases, and the general population interested in personal health and fitness measures. Specifically, to the best of our knowledge, this patch represents the first demonstration of combined activity, environmental context, and hemodynamics monitoring, all on the same hardware, capable of operating for longer than 48 hours at a time with continuous recording. The three-channels of SCG and one-lead ECG are all sampled at 500 Hz with high signal-to-noise ratio, the pressure sensor is sampled at 10 Hz, and all signals are stored to a microSD card with an average current consumption of less than 2 mA from a 3.7 V coin cell (LIR2450) battery. In addition to electronic characterization, proof-of-concept exercise recovery studies were performed with this patch, suggesting the ability to discriminate between hemodynamic and electrophysiology response to light, moderate, and heavy exercise